Sexual Intercourse - Painful

Illustrations

For both men and women, pain can occur in the pelvic area during or soon after sexual intercourse. It can happen at any time during sex -- for example, at the time of penetration, erection, or ejaculation -- or after sexual activity.

Eventually, ongoing pain may cause a person to lose interest in any sexual activity.

Sex therapy may be helpful, especially if no underlying medical cause is identified. Guilt, inner conflict, or unresolved feelings about past abuse may be involved which need to be worked through in therapy. It may be best for your partner to see the therapist with you.

You have other symptoms with painful intercourse, like bleeding, genital lesions, irregular periods, discharge from penis or vagina, or involuntary vaginal muscle contraction.

If you have been sexually assaulted, report the crime to the police and go to the emergency room immediately. Get a trusted friend to accompany you. Do NOT change, bathe, shower or even wash your hands before the ER evaluation. The temptation to do so will be great, but it is important to not lose any evidence in order to help find, charge, and convict the suspect.

Your doctor will take your medical history and perform a physical examination.

Medical history questions may include:

When did the pain begin or has intercourse always been painful?

Is intercourse painful every time that it is attempted?

Is it painful for your partner as well?

At what point during (or after) intercourse does the pain begin? Upon entry/penetration? During ejaculation?

Where, specifically, is the pain?

Does anything make the pain better?

Do you have any other symptoms?

What are your attitudes towards sex in general?

Have you had a significant traumatic event in the past (rape, child abuse, or similar)?

What medications do you take?

What illnesses, diseases, and disorders are you being treated for?

Have you had a significant emotional event recently?

Have you ever had pain-free sex with this partner? With any partner?

It may be best to see the doctor together with your partner. Physical examination may include a pelvic examination (for women), a prostate examination (for men), and a rectal examination. If a physical problem is suspected, appropriate tests will be ordered.

Antibiotics, painkillers, or hormones are amongst the treatment options that may be considered.

Adequate foreplay and stimulation will help to ensure proper lubrication of the vagina.

The use of a water-soluble lubricant like K-Y Jelly may also help. Vaseline should not be used as a sexual lubricant because it is not compatible with latex condoms (it causes them to break), it is not water soluble, and it may encourage vaginal infections.

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